Healthcare Provider Details

I. General information

NPI: 1891863809
Provider Name (Legal Business Name): ROBERT LAURENCE OKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 1ST AVE
NAPA CA
94558-3828
US

IV. Provider business mailing address

2111 1ST AVE
NAPA CA
94558-3828
US

V. Phone/Fax

Practice location:
  • Phone: 415-722-2417
  • Fax:
Mailing address:
  • Phone: 415-722-2417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG70108
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: